The blue economy purportedly involves equitable and sustainable development across a range of ocean sectors spanning fisheries, aquaculture, tourism, shipping, seabed mining, oil and gas extraction, and renewable energy. Here, we argue that blue economy scholarship and policy gives insufficient attention to coastal regions – and the cities, towns, and villages within – that depend on these sectors. Rather than prioritising the profitability of corporations and expansion of industry, we advise actors to consider three transformative processes that are (re)shaping coastal regions. First, are techno-industrial processes for which we draw on the fourth industrial revolution literature, highlighting that coastal regions must adapt to rapidly changing technological innovations or risk facing decline. Second, are socio-cultural processes for which we draw on the left-behind places literature, which exemplifies spatial inequalities from declining and deindustrialised coastal regions. Third, are physical-environmental processes, highlighting geographically variable opportunities and challenges around natural resources, marine biodiversity, and climate change in coastal regions. We then promote place-based policymaking as a multi-level and participatory mode of managing these transformations. Finally, we present a blue economy research agenda to help navigate these transformative processes, and enable place-based solutions. The article intersects with broader literatures around ocean governance and sustainable transformations.